Bone gentamicin concentration after intra‐articular injection or regional intravenous perfusion in the horse

Werner, Laura A.; Hardy, Joanne; Bertone, Alicia L.

doi:10.1111/j.1532-950x.2003.00559.x

Cited by 88 publications

(107 citation statements)

References 16 publications

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“…Antibiotics injected into synovial joints are absorbed in a manner similar to antibiotics injected intramuscularly and produce similar serum concentration [13,27], so some peripheral therapeutic antibiotic effect would be expected. Antibiotics injected directly into the joint produce concentrations substantially higher in the adjacent bone than can be achieved with intravenous administration [17,35]. This suggests local antibiotic concentration in the bone and soft tissue beyond the synovial membrane would more likely be bactericidal with intraarticular than with intravenous administration of antibiotics.…”

Section: Discussionmentioning

confidence: 88%

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Reinfected Revised TKA Resolves With an Aggressive Protocol and Antibiotic Infusion

Whiteside

Nayfeh

LaZear

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Revision of failed two-stage revision TKA for infection is challenging, and amputation often is the only alternative. Questions/purposes We asked whether reinfection after two-stage revision for infection could be controlled with an aggressive revision protocol and intraarticular antibiotic infusion. Methods We retrospectively reviewed 18 patients (12 women, six men) who underwent revision

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Section: Discussionmentioning

confidence: 88%

“…Intravenous antibiotics achieve adequate joint levels only briefly [13,17,22,23,26,35]; and antibiotic-loaded cement spacers are depleted of available antibiotics after 3 to 7 days and thereafter become a potential nidus for growth of infecting organisms [2,26,32].…”

Section: Introductionmentioning

confidence: 99%

Reinfected Revised TKA Resolves With an Aggressive Protocol and Antibiotic Infusion

Whiteside

Nayfeh

LaZear

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Regional limb perfusion with antimicrobials might be more effective in preventing or treating infection in the subchondral bone, although gentamicin concentrations in subchondral bone after A-RLP were not different from those achieved after intra-articular administration in healthy horses. 54 Reported rates for return to previous level of athletic use in horses with septic synovitis and lacerations to synovial structures are 40% to 60%. 15,24,36,[38][39][40] In our study, 48% of horses with septic synovitis returned to the previous or intended athletic use, and from those horses, 80% were performing at the same or at a higher level than before.…”

Section: Discussionmentioning

confidence: 99%

Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009)

Rubio‐Martínez

Elmas²,

Black³

et al. 2012

javma

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Objective—To describe the clinical use of regional limb perfusion with antimicrobials (A-RLP), complications, and outcome in a large series of patients. Design—Retrospective case series. Animals—174 horses. Procedures—Medical records of horses treated with A-RLP between 1999 and 2009 were reviewed. Signalment, primary complaint, horse use, etiology, duration of clinical signs, previous treatment, structures involved, concurrent conditions, A-RLP characteristics, additional treatments, complications, and outcome were recorded. At long-term follow-up, 2 outcomes were investigated: survival rate and return to previous use at the same or higher level. Univariate and multivariate logistic regression analyses were conducted. Results—Group 1 (96 horses) included septic synovitis. Group 2 (50 horses) included extrasynovial lacerations (23 horses) and fresh, minimally contaminated intrasynovial lacerations without evidence of established synovial infection (27 horses). Group 3 (28 horses) included miscellaneous other conditions. Only minor complications were reported in 12.26% of horses that received IV (n = 155) and 33% of horses that received intraosseous (27) A-RLP. Horses with septic synovitis had a lower survival rate (53.43%) than did horses with lacerations (91.89%). Within group 2, no significant differences in short- or long-term outcomes were found between horses with extrasynovial and fresh, minimally contaminated intrasynovial lacerations. For the horses returning to previous use, 80% of horses with septic synovitis and 72.72% of horses with lacerations were performing at the same or higher level at the time of follow-up. Conclusions and Clinical Relevance—The results of the present study indicated that A-RLP is a safe technique with minimal adverse effects. The IV route presented fewer complications than intraosseous injection. Horses with infection of synovial structures had a lower survival rate than did those with acute, minimally contaminated intrasynovial lacerations. The latter had a similar prognosis for horses with extrasynovial lacerations treated with A-RLP.

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“…Συγκριτική μελέτη της ενδοαρθρι-κής έγχυσης αντιβακτηριδιακής ουσίας με την ενδο φλέβια DLP καταγράφει επίτευξη θεραπευτικών συγ κεντρώσεων στο αρθρικό υγρό της μετακαρπιοφα-λαγγικής άρθρωσης και για τις δύο μεθόδους, οι υψη λότερες, όμως, επιτυγχάνονται κατά την ενδοαρθρική έγχυση. Κατά την ενδοαρθρική έγχυση αντιβακτηρι-διακών ουσιών, όπως και με την DLP, οι ουσίες αυτές δεν ανιχνεύονται στο πλάσμα του αίματος και συνεπώς δεν προκαλούν τις παρενέργειες της συστηματικής χο ρήγησης αντιβακτηριδιακών ουσιών (Werner et al 2003). Το μειονέκτημα της, όμως, σε σχέση με την DLP είναι πως η πρώτη, σε αντίθεση με τη δεύτερη, δεν επιτυγχάνει υψηλές συγκεντρώσεις αντιβακτηρι διακών στους περιαρθρικούς ιστούς (Whitehair et al 1992b, Pille et al 2005.…”

Section: συζητηση-συμπερασματαunclassified

“…Η γενταμυκίνη είναι λιγότερη αποτελεσματική από την αμικακίνη, εμφανίζει περισσότερες παρενέργειες και είναι πιο πιθανή η ανάπτυξη βακτηριδιακής αντοχής σε αυτήν (Moore et al 1992, Murphey et al 1999, Scheuch et al 2002. Επιπλέον, η γενταμυκίνη ίσως να μην είναι η καταλληλότερη για την αντιμετώπιση ση πτικών καταστάσεων των οστών, καθώς γενικότερα δεν πετυχαίνει υψηλές συγκεντρώσεις στον οστίτη ιστό (Werner et al 2003). Παρ' όλα αυτά, οι Mattson et al (2004) αναφέρουν καλή ανταπόκριση μυοσκελετικών λοιμώξεων σε αυτήν.…”

Section: επιλογή της αντιβακτηριδιακης ουσίαςunclassified

Distal limb perfusion with amikacin in two horses

Zamboulis

Diakakis

2018

J Hellenic Vet Med Soc

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Distal Limb Perfusion (DLP) involves the administration of a drug into the vasculature of a selected portion of thelimb that has been isolated from the systemic circulation by the application of a tourniquet (Rubio-Martinez and Cruz 2006). It is used to achieve high tissue concentrations of an antimicrobial in septic sites, while reducing undesirable systemic effects (Errico et al. 2008). DLP has been used as an adjunctive therapy in the treatment of sepsis improving greatly the outcome (Kramer 2006). In the present study, two cases of elimination of musculoskeletal sepsis are being presented. The first case is about a horse with chronic, partial hoof avulsion injury and infection of soft tissues. The second case is about a foal that presented with osteomyelitis of the third metatarsus bone. Both cases where treated with surgical debridment of the affected areas in conjuction with DLP and systemic therapy. For the first case, DLP targeted the hoof and it was performed through the lateral palmar digital vein with a solution of 125 mg of amikacin (Briklin®, Bristol-Myers Squibb) in 30 mL of 0,9% NaCl solution. For the second case, DLP targeted the metatarsus and it was performed through the medial saphenous vein with a solution of 250 mg of amikacin (Briklin®, Bristol-Myers Squibb) in 60 mL of 0,9% NaCl solution. The outcome of both patients was good despite their bad prognosis. DLP is a simple and effective method for treatment of septic conditions of the horse's distal limb, which is nowadays growing in popularity with promising results.

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Bone gentamicin concentration after intra‐articular injection or regional intravenous perfusion in the horse

Abstract: Based on MIC for common equine pathogens, administration of gentamicin intra-articularly or by regional intravenous perfusion should be useful for treatment of osteomyelitis.

Cited by 88 publications

References 16 publications

Reinfected Revised TKA Resolves With an Aggressive Protocol and Antibiotic Infusion

Reinfected Revised TKA Resolves With an Aggressive Protocol and Antibiotic Infusion

Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009)

Distal limb perfusion with amikacin in two horses

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